Anaesthetic management of a parturient with an unrepaired coronary arteriovenous fistula for caesarean section.

Coronary arteriovenous fistulas are an abnormal conduit between a coronary artery and another cardiovascular lumen, without an intervening capillary bed. The reported prevalence is 0.002-0.3%. Physiologic consequences such as congestive heart failure, coronary steal phenomenon and fistula aneurysm formation and rupture are possible. There are limited reports of symptomatic coronary arteriovenous fistulas in association with pregnancy. We describe a 19-year-old woman with symptomatic left circumflex artery to coronary sinus fistula, terminating into a large exophytic varix in the right atrium, presenting for an elective caesarean section at 37 weeks gestational age. Our anaesthetic management strategy aimed to optimise myocardial perfusion, maintain euvolemia, avoid right ventricular obstruction from exophytic varix and avoid sympathetic stimulation or sudden increases in pulmonary vascular resistance. A slowly titrated epidural was used as the primary anaesthetic. Our patient tolerated the procedure well and was discharged home on postoperative day two. Understanding of the potential physiologic consequence of coronary arteriovenous fistulas, and interaction with the physiologic changes of pregnancy and delivery, are essential for the management of these cases.

Prenatal exposure to acrylamide differently affected the sex ratio, aromatase and apoptosis in female adult offspring of two subsequent generations.

In the present study, we investigated the effect of acrylamide (ACR) exposure during pregnancy on the ovary of female adult offspring of two subsequent generations. Sixty-day-old Wistar albino female rats were given different doses of ACR (2.5 and 10 mg/kg/day) from day 6 of pregnancy until giving birth. Females from the first generation (AF1) were fed ad libitum, and thereafter, a subgroup was euthanized at 8 weeks of age and ovary samples were obtained. The remaining females were maintained until they reached sexual maturity (50 days old) and then treated in the same way as the previous generation to obtain the second generation of females (AF2). The histopathological examination indicated a high frequency of corpora lutea along with an increased number of antral follicles that reached the selectable stage mainly at a dose of 2.5 mg/kg/day. Interestingly, ACR exposure significantly increased the mRNA levels of CYP19 gene and its corresponding CYP19 protein expression in AF1 females. The TUNEL assay showed a significantly high rate of apoptosis in stromal cells except for dose of 2.5 mg/kg/day. However, in AF2 females, ACR exposure significantly increased the number of degenerating follicles and cysts while the number of growing follicles was reduced. Moreover, in both ACR-treated groups, estradiol-producing enzyme CYP19A gene and its corresponding protein were significantly reduced, and an excessive apoptosis was produced. We concluded that the ovarian condition of AF1 females had considerable similarity to the typical early perimenopausal stage, whereas that of AF2 females was similar to the late perimenopausal stage in women.

Effects of ferroelectric oxides of barium strontium titanate (Ba0.85Sr0.15TiO3) nanoparticles on Ruditapes decussatus assessed through chemical, physiological, and biochemical methods.

Here, the effects of a newly designed ferroelectric oxide synthesized by solid reaction, barium strontium titanate [BST (85/15)] (Ba0.85Sr0.15TiO3), on the carpet shell clam Ruditapes decussatus were investigated. These clams were exposed to four concentrations of BST (85/15) nanoparticles (0.001, 0.01, 0.1, and 1 mg.L-1), and BST (85/15) was absorbed by R. decussatus in an exposure intensity-dependent manner. Measurements of clearance rate and biomarkers confirmed that the nanoparticles significantly affected the health of clams in an organ-dependent manner. Interestingly, BST (85/15) nanoparticles stimulated acetylcholinesterase (AChE) activity in the clams, suggesting their usefulness as antagonists of AChE inhibiting pollutants. These findings demonstrate the suitability of R. decussatus as a test organism to provide a framework for understanding the toxicological effects of these newly designed ferroelectrics. Moreover, concentrations of BST (85/15) < 0.1 mg.L-1 could be good alternatives to lead-based ferroelectric oxides and could be sustainable tools for use in electronic applications.